Wednesday, April 30, 2014

On this
side lay Scylla while on that Charybdis in her terrible whirlpool was sucking
down the sea.

Homer(700
BC), Odyssey XII

The
strongest principle of growth lies in human choice.

George
Eliot (1811-1880)

ObamaCare reminds me of the Greek myth of Scylla and Charybdis. Scylla was a loathsome dark monster (the
uninsured), inhabiting an inacessible cave
on an unscalable rock;Charybdis ( capitalism
) was a fatal whirlpool (sucking down
the poor).

The two represent the dreadful alternatives between which
one must make a choice.

In the case of ObamaCare, the choice may be between economic
growth , which in the U.S. in the first quarter of 2014 was a dreadful 0.1%,and the narrowed choice of health care
providers and health exchange plansoffering average premium increases of 47% and $6000 deductibles.

Texas is a good example of the dilemma facing
Americans.Texas has the nation’s second
highest GDP growth rate of 4.8% (after shale-rich North Dakota at 13.4%), yet
Texas ranks dead last in the number of uninsured at 26.3%.

The American people have made their choice.
The Texas population has grown 20.1% versus 9.0% for the rest of the U.S.over the last decade.Texas added 1.3 million people from 2010 to
2013, more than any other state, pushing past 26 million.Its
unemployment rate is 5.5% compared to the U.S. average of 6.7%.Half of the nation’s 10 fastest growing
cities are in Texas.

Liberals heap scorn on Texas, accusing Texans
of being all hat and no saddle,all
business and no heart.But people from
other states,including liberal
California, do not agree. One quarter of Texas new residents hail from the Golden
State.And international and national
corporationsdo not agree.. Toyota just
moved its North American headquarters to Plano, Texas.

Physicians are also moving to Texas in record numbers
because of its lower taxes,lower costs
of doing business, and low malpractice rates. As I indicated in a July 1,
2012 blog, Texas may represent the future of health care. Three quarters of
Texas physicians are from other states.

All of this inward migration to Texas indicates that robust
economic growthand low unemployment are higher priorities for Americans and their physicians
than ObamaCare.

The moral of this tale may be: Don't mess with Texas. It knows what it is doing.

Tweet:Economic
growth and unemployment are more important than ObamaCarefor Americans and their physicians.

Tuesday, April 29, 2014

ObamaCare
and the 3Rs**

Reading,
‘Riting, and ‘Rithmetic

Reading,
‘Riting, and ‘Rithmetic are education basics.In talking of ObamaCare, however, if you are
a vulnerable Democratrunning for reelection
to Congress,you avoid the other 3Rs -Reform,Recovery, and Rationing.

'Riting about it is hazardous. You may be quoted by the
opposition as hopelessly naïve and out of touch with reality.

And the 'Rithmetic s daunting when you consider its impact on premiums,deductibles, costs,and the
economy. It is a exercis in math with more negatives than positives.

In the words of Alice
in Wonderland, Reform is about “Reeling and Writhing, to begin with,
and the different branches of Arithmetic – Ambition, Distraction, Uglification,
and Derision.”

“Reform,” of course, refers to ObamaCare, which was designed
to wipe out the uninsured and to replace it with government subsidies and
Medicaid expansion."Reform" was intended to
cement the legacy of the President and his party as purveyors and guarantors of
the entitlement state and to cement their hold on political power.Instead “Reform” has become an
albatross,if you believe the polls, which
are 96% negative on dislike of the health law; the President’s approval rating,
which has dipped to 41%, and the disinclination of Democrats to even talk about
reform,especially in those seven red
states up for Senatorial grabs.

As far as the second “R”, Recovery, the question is” What
'Recovery'”?Over the last 5 years,economic growth has averaged 1.8% compared to
3% to 4% growth in other recoveries since World War II.And last month,a NBC/Wall
Street Journal poll showed 57% of Americans think the U.S. is still in a
"Recession", another “R” word to be avoided except to say the "Recession" is due to
those double R, “Rotten Republicans,”
who got us in the deep hole we are in
today.

The 3rd R,“Rationing,”is another No-No
word for Democrats. It smacks of socialism and the rationing that always
goes on in countries with that form of government.But, alas, “Rationing” in subtle forms is
precisely what Americans are getting - “Rationing”
of numbers and information as to who makes up those 8 million who signed up for
health exchanges, “Rationing”, pardon“Narrowing of the Networks, “ of the
hospitals and doctors who will accept health exchange patients, “Rationing” by
waiting as you try to find a primary care doctor or a specialist who will
accept you as a patient at those low government rates, “Rationing” of resources
for Medicare Advantage patients, and “Rationing” of personal liberties and
choices of heath plans.

You hit
singles, you hit doubles; every once in a while we may
be able to hit a home run.

President Obama at April 28, 2014 news conference on Ukraine

Think of the Presidency as a series of baseball games. Each game has
hits, runs, and errors. Each game has a winner and loser.Each game is part of a long season and a
pennant race. Each game has an
opponent.

The baseball field has an infield – domestic policy- and an
outfield – foreign policy.The infield
players are members of the President's administration.The
outfield players are the state department and your military advisors. The vast
audience now at the park consists of 315 million Americans.

Now consider the current ObamaCare game.It is the fourth inning (The President is just over half way through his second term).The outcome remains in doubt.The President's opponents, the Republicans, a ragtag
team with established players and rookie upstarts, are putting up a tough
fight. The President 's team have just been up to bat,
and they have just scored 8 million runs.The President claims he has hit a home run, and the
game is over. His opponents, and the
umpires dispute his call, and so does the crowd at the park.

His troubles are twofold:

·The fat lady has yet to sing, and she will not
sing under after the November midterms, which is analogous to the All-Star break
half-way through the season.

·The other side has still not had all its turns
at bat.They will swing for the fences
until November, and no one knows how many runs they will score.

For the President to declare he's the winner because his team has 8 million runs is a bit of a stretch.Let’s call it the 5th year
stretch.He may think you’ve crossed
home plate, and that, as President, you’re the winner. But the outcome remains
in doubt.

You will not know how much your 8 million runs mean until
the statistician sorts out the numbers behind your runs.And the runs may look meaningless when the
health plans announce their premium hikes in late May or early June, just
halfway through the election season.If
premiums double, as WellPoint and health care agents expect, 8 million
runs may be inadequate to win the game.

It’s a long season, Mr. President, and in this particular
game. You have just hit a single. You are now trying to steal second base. Your opponents hope to cut you down by executing a double play
by winning the House and Senate.

The throw from the catcher may be on time or late. The catcher is right handed, and his vision is partially obscured by a left handed batter. The outcome of the game hangs in the balance. The other team is error-prone, and results of other games in other
fields of play – the economy, other states, and foreign policy – may determine
the outcome of this particular game.

Tweet: Obama Care can be compared to a baseball
game, with hits, runs, and errors, and an uncertain outcome until the final
inning is played.

**To
comment on this blog or contact the author, call 1-860-395-1501 or e-mail
doctor. reece@gmail.com

Monday, April 28, 2014

In a presentation I am giving before a group of hospital
chaplains,I comment:

“There are two ways of looking at health reform – from top-down
government or bottom-up markets."

It’s a hard choice.How does one strike the balance between economic growth, which
unevenlylifts all boats with freedom to choose;andeconomic stagnation, which treats everybody equally, but leaves everyone
in the boat choiceless and voiceless?

Tweet:Churchill:
“The chief vice of capitalism is the unequal sharing of blessing: the chief
virtue of socialism is the equal sharing of misery.”

** For comment or contact,
call Richard Reece MD at 1-860-395-1501 or e-mail me at doctor.reece@gmail.com

The Health Reform Maze

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